H.B. 351

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NURSE PRACTICE ACT AMENDMENTS
2 1998 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Christine R. Fox-Finlinson
5 AN ACT RELATING TO OCCUPATIONS AND PROFESSIONS; REPEALING THE
6 EXISTING NURSE PRACTICE ACT AND ENACTING A NEW NURSE PRACTICE ACT
7 IN ITS PLACE; DEFINING TERMS; ESTABLISHING DIFFERENT LICENSING
8 CLASSIFICATIONS; DEFINING THE SCOPE OF PRACTICE AND QUALIFICATIONS
9 FOR EACH CLASSIFICATION; EXTENDING PRESCRIPTIVE AUTHORITY TO
10 CERTAIN LICENSEES; CREATING A NURSING BOARD; AUTHORIZING THE
11 NURSING BOARD TO DENY, APPROVE, OR WITHDRAW APPROVAL OF AN
12 EDUCATIONAL PROGRAM; ESTABLISHING AN EXECUTIVE ADMINISTRATOR FOR
13 THE BOARD; AUTHORIZING THE IMPOSITION OF ADMINISTRATIVE FINES FOR
14 UNPROFESSIONAL CONDUCT; CREATING A RESTRICTED ACCOUNT INTO WHICH
15 ADMINISTRATIVE FINES ARE PLACED AND APPROPRIATED FOR ACTIVITIES
16 RELATED TO THE REGULATION OF NURSING; CREATING A PRESCRIPTIVE
17 PRACTICE ADVISORY PEER COMMITTEE; AUTHORIZING CONTINUING
18 EDUCATION REQUIREMENTS TO BE ESTABLISHED BY RULE; AUTHORIZING THE
19 IMMEDIATE SUSPENSION OF A LICENSE UNDER CERTAIN CIRCUMSTANCES;
20 DEFINING UNPROFESSIONAL AND UNLAWFUL CONDUCT; EXTENDING
21 IMMUNITY TO ORGANIZATIONS THAT REPORT PROFESSIONAL MISCONDUCT IN
22 GOOD FAITH; AMENDING THE LAW GOVERNING NURSE MIDWIVES TO INCLUDE
23 ADMINISTRATIVE PENALTIES, THE CREATION OF A RESTRICTED ACCOUNT, AND
24 CONTINUING EDUCATION REQUIREMENTS; MAKING CONFORMING AND
25 TECHNICAL AMENDMENTS; AND PROVIDING AN EFFECTIVE DATE.
26 This act affects sections of Utah Code Annotated 1953 as follows:
27 AMENDS:

1 58-13-2, as last amended by Chapter 248 and renumbered and amended by Chapter 253, Laws
2 of Utah 1996
3 58-13-3, as last amended by Chapter 248 and renumbered and amended by Chapter 253, Laws
4 of Utah 1996
5 58-44a-102, as last amended by Chapter 10, Laws of Utah 1997
6 58-44a-201, as enacted by Chapter 187, Laws of Utah 1994
7 58-44a-301, as enacted by Chapter 187, Laws of Utah 1994
8 58-44a-302, as last amended by Chapter 28, Laws of Utah 1995
9 58-44a-303, as enacted by Chapter 187, Laws of Utah 1994
10 58-44a-305, as enacted by Chapter 187, Laws of Utah 1994
11 75-5-311, as last amended by Chapter 161, Laws of Utah 1997
12 78-14-3, as last amended by Chapters 232, 247, 248 and 282, Laws of Utah 1996
13 ENACTS:
14 26-21-22, Utah Code Annotated 1953
15 58-31b-101, Utah Code Annotated 1953
16 58-31b-102, Utah Code Annotated 1953
17 58-31b-103, Utah Code Annotated 1953
18 58-31b-201, Utah Code Annotated 1953
19 58-31b-202, Utah Code Annotated 1953
20 58-31b-301, Utah Code Annotated 1953
21 58-31b-302, Utah Code Annotated 1953
22 58-31b-303, Utah Code Annotated 1953
23 58-31b-304, Utah Code Annotated 1953
24 58-31b-305, Utah Code Annotated 1953
25 58-31b-306, Utah Code Annotated 1953
26 58-31b-307, Utah Code Annotated 1953
27 58-31b-308, Utah Code Annotated 1953
28 58-31b-309, Utah Code Annotated 1953
29 58-31b-401, Utah Code Annotated 1953
30 58-31b-402, Utah Code Annotated 1953
31 58-31b-501, Utah Code Annotated 1953

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1 58-31b-502, Utah Code Annotated 1953
2 58-31b-503, Utah Code Annotated 1953
3 58-31b-601, Utah Code Annotated 1953
4 58-31b-701, Utah Code Annotated 1953
5 58-31b-702, Utah Code Annotated 1953
6 58-31b-801, Utah Code Annotated 1953
7 58-44a-103, Utah Code Annotated 1953
8 58-44a-402, Utah Code Annotated 1953
9 58-44a-502, Utah Code Annotated 1953
10 58-44a-503, Utah Code Annotated 1953
11 REPEALS AND REENACTS:
12 58-44a-501, as enacted by Chapter 187, Laws of Utah 1994
13 58-44a-601, as enacted by Chapter 187, Laws of Utah 1994
14 REPEALS:
15 58-31-1, as repealed and reenacted by Chapter 82, Laws of Utah 1992
16 58-31-2, as last amended by Chapter 10, Laws of Utah 1997
17 58-31-3, as last amended by Chapter 187, Laws of Utah 1994
18 58-31-4, as last amended by Chapter 297, Laws of Utah 1993
19 58-31-5, as last amended by Chapter 10, Laws of Utah 1997
20 58-31-6, as repealed and reenacted by Chapter 297, Laws of Utah 1993
21 58-31-6.5, as enacted by Chapter 297, Laws of Utah 1993
22 58-31-7, as last amended by Chapter 28, Laws of Utah 1995
23 58-31-8, as repealed and reenacted by Chapter 82, Laws of Utah 1992
24 58-31-9, as last amended by Chapter 28, Laws of Utah 1995
25 58-31-10, as last amended by Chapter 28, Laws of Utah 1995
26 58-31-11, as last amended by Chapter 297, Laws of Utah 1993
27 58-31-12, as repealed and reenacted by Chapter 82, Laws of Utah 1992
28 58-31-13, as last amended by Chapter 297, Laws of Utah 1993
29 58-31-13.5, as enacted by Chapter 297, Laws of Utah 1993
30 58-31-15, as last amended by Chapter 297, Laws of Utah 1993
31 58-31-16, as repealed and reenacted by Chapter 82, Laws of Utah 1992

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1 58-31-17, as last amended by Chapter 297, Laws of Utah 1993
2 58-31-18, as enacted by Chapter 82, Laws of Utah 1992
3 58-31-19, as last amended by Chapter 10, Laws of Utah 1997
4 58-31-20, as enacted by Chapter 82, Laws of Utah 1992
5 58-31-21, as enacted by Chapter 82, Laws of Utah 1992
6 58-31-22, as enacted by Chapter 82, Laws of Utah 1992
7 58-44a-701, as enacted by Chapter 187, Laws of Utah 1994
8 Be it enacted by the Legislature of the state of Utah:
9 Section 1. Section 26-21-22 is enacted to read:
10 26-21-22. Reporting of disciplinary information -- Immunity from liability.
11 A health care facility licensed under this chapter which reports disciplinary information on
12 a licensed nurse to the Division of Occupations and Professions within the Department of
13 Commerce as required by Section 58-31b-702 is entitled to the immunity from liability provided
14 by that section.
15 Section 2. Section 58-13-2 is amended to read:
16 58-13-2. Emergency care rendered by licensee.
17 A person licensed under Title 58, Occupations and Professions, to practice as any of the
18 following health care professionals, who is under no legal duty to respond, and who in good faith
19 renders emergency care at the scene of an emergency gratuitously and in good faith, is not liable
20 for any civil damages as a result of any acts or omissions by the person in rendering the emergency
21 care:
22 (1) osteopathic physician;
23 (2) physician and surgeon;
24 (3) naturopath;
25 (4) dentist or dental hygienist;
26 (5) chiropractic physician;
27 (6) physician assistant; or
28 (7) nurse licensed [in a classification] under [Subsection 58-31-6(2)] Section 58-31b-301.
29 Section 3. Section 58-13-3 is amended to read:
30 58-13-3. Qualified immunity -- Health professionals -- Charity care.
31 (1) (a) The Legislature finds many residents of this state do not receive medical care and

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1 preventive health care because they lack health insurance or because of financial difficulties or
2 cost. The Legislature also finds that many physicians, charity health care facilities, and other
3 health care professionals in this state would be willing to volunteer medical and allied services
4 without compensation if they were not subject to the high exposure of liability connected with
5 providing these services.
6 (b) The Legislature therefore declares that its intention in enacting this section is to
7 encourage the provision of uncompensated volunteer health care in charity care settings in
8 exchange for a limitation on liability for the health care facilities and health care professionals who
9 provide those volunteer services.
10 (2) As used in this section:
11 (a) "Health care facility" means any clinic or hospital, church, or organization whose
12 primary purpose is to sponsor, promote, or organize uncompensated health care services for people
13 unable to pay for health care services.
14 (b) "Health care professional" means individuals licensed under Title 58, Occupations and
15 Professions, as physicians and surgeons, osteopaths, podiatrists, chiropractors, dentists, dental
16 hygienists, registered nurses, certified nurse midwives, and other nurses [in license classifications]
17 licensed under [Subsection 58-31-6(2)] Section 58-31b-301.
18 (c) "Remuneration or compensation":
19 (i) (A) means direct or indirect receipt of any payment by the physician and surgeon,
20 health care facility, other health care professional, or organization, on behalf of the patient,
21 including payment or reimbursement under medicare or medicaid, or under the state program for
22 the medically indigent on behalf of the patient; and
23 (B) compensation, salary, or reimbursement to the health care professional from any
24 source for the health care professional's services or time in volunteering to provide uncompensated
25 health care; and
26 (ii) does not mean any grant or donation to the health care facility used to offset direct
27 costs associated with providing the uncompensated health care such as medical supplies or drugs.
28 (3) A health care professional who provides health care treatment at a health care facility
29 is not liable in a medical malpractice action if:
30 (a) the treatment was within the scope of the health care professional's license under this
31 title;

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1 (b) neither the health care professional nor the health care facility received compensation
2 or remuneration for the treatment;
3 (c) the acts or omissions of the health care professional were not grossly negligent or
4 willful and wanton; and
5 (d) prior to rendering services, the health care professional disclosed in writing to the
6 patient, or if a minor, to the patient's parent or legal guardian, that the health care professional is
7 providing the services without receiving remuneration or compensation and that in exchange for
8 receiving uncompensated health care, the patient consents to waive any right to sue for
9 professional negligence except for acts or omissions which are grossly negligent or are willful and
10 wanton.
11 (4) A health care facility which sponsors, promotes, or organizes the uncompensated care
12 is not liable in a medical malpractice action for acts and omissions if:
13 (a) the health care facility meets the requirements in Subsection (3)(b);
14 (b) the acts and omissions of the health care facility were not grossly negligent or willful
15 and wanton; and
16 (c) the health care facility has posted, in a conspicuous place, a notice that in accordance
17 with this section the health care facility is not liable for any civil damages for acts or omissions
18 except for those acts or omissions that are grossly negligent or are willful and wanton.
19 (5) Immunity from liability under this section does not extend to the use of general
20 anesthesia or care that requires an overnight stay in a general acute or specialty hospital licensed
21 under Title 26, Chapter 21, Health Care Facility [Licensure] Licensing and Inspection Act.
22 Section 4. Section 58-31b-101 is enacted to read:
23 CHAPTER 31b. NURSE PRACTICE ACT
24 Part 1. General Provisions
25 58-31b-101. Title.
26 This chapter is known as the "Nurse Practice Act."
27 Section 5. Section 58-31b-102 is enacted to read:
28 58-31b-102. Definitions.
29 In addition to the definitions in Section 58-1-102, as used in this chapter:
30 (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
31 omissions determined to constitute unprofessional or unlawful conduct in accordance with a fine

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1 schedule established by rule and as a result of an adjudicative proceeding conducted in accordance
2 with Title 63, Chapter 46b, Administrative Procedures Act.
3 (2) "Applicant" means a person who applies for licensure under this chapter by submitting
4 a completed application for licensure and the required fees to the department.
5 (3) "Approved education program" means a nursing education program that meets the
6 minimum standards for educational programs established under this chapter and by division rule
7 in collaboration with the board.
8 (4) "Board" means the Board of Nursing created in Section 58-31b-201.
9 (5) "Consultation and referral plan" means a written plan jointly developed by an advanced
10 practice registered nurse and a consulting physician that permits the advanced practice registered
11 nurse to prescribe schedule II-III controlled substances in consultation with the consulting
12 physician.
13 (6) "Consulting physician" means a physician and surgeon or osteopathic physician and
14 surgeon licensed in accordance with this title who has agreed to consult with an advanced practice
15 registered nurse with a controlled substance license, a DEA registration number, and who will be
16 prescribing schedule II-III controlled substances.
17 (7) "Diagnosis" means the identification of and discrimination between physical and
18 psychosocial signs and symptoms essential to effective execution and management of health care.
19 (8) "Examinee" means a person who applies to take or does take any examination required
20 under this chapter for licensure.
21 (9) "Licensee" means a person who is licensed under this chapter.
22 (10) "Practice of nursing" means assisting individuals or groups to maintain or attain
23 optimal health, implementing a strategy of care to accomplish defined goals and evaluating
24 responses to care and treatment. The practice of nursing requires substantial specialized or general
25 knowledge, judgment, and skill based upon principles of the biological, physical, behavioral, and
26 social sciences, and includes:
27 (a) initiating and maintaining comfort measures;
28 (b) promoting and supporting human functions and responses;
29 (c) establishing an environment conducive to well-being;
30 (d) providing health counseling and teaching;
31 (e) collaborating with health care professionals on aspects of the health care regimen;

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1 (f) performing delegated procedures only within the education, knowledge, judgment, and
2 skill of the licensee; and
3 (g) delegating nurse interventions that may be performed by others and are not in conflict
4 with this chapter.
5 (11) (a) "Practice of nurse anesthesia" means the practice of nursing related to the
6 provision of preoperative, intraoperative, and postoperative anesthesia care and related services
7 upon the request of a physician, surgeon, or other licensed professional, who is acting within the
8 scope of their practice, by a person licensed under this chapter as a certified registered nurse
9 anesthetist and includes:
10 (i) preanesthesia preparation and evaluation including:
11 (A) performing a preanesthetic assessment of the patient;
12 (B) ordering and evaluating appropriate lab and other studies to determine the health of
13 the patient; and
14 (C) selecting, ordering, or administering appropriate medications;
15 (ii) anesthesia induction, maintenance, and emergence, including:
16 (A) selecting and initiating the planned anesthetic technique;
17 (B) selecting and administering anesthetics and adjunct drugs and fluids; and
18 (C) administering general, regional, and local anesthesia;
19 (iii) postanesthesia follow-up care, including:
20 (A) evaluating the patient's response to anesthesia and implementing corrective actions;
21 and
22 (B) selecting, ordering, or administering the above medications and studies; and
23 (iv) other related services within the scope of practice of a certified registered nurse
24 anesthetist, including:
25 (A) emergency airway management;
26 (B) advanced cardiac life support; and
27 (C) the establishment of peripheral, central, and arterial invasive lines.
28 (b) Nothing in this section shall be construed as to require a certified registered nurse
29 anesthetist to obtain an advance practice registered nurse licensure in order to select, administer,
30 or provide preoperative, intraoperative, or postoperative anesthesia care and services.
31 (12) "Practice of practical nursing" means the performance of nursing acts in the generally

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1 recognized scope of practice of licensed practical nurses as defined by rule and as provided in this
2 Subsection (12) by a person licensed under this chapter as a licensed practical nurse and under the
3 direction of a registered nurse, licensed physician, or other specified health care professional as
4 defined by rule. Practical nursing acts include:
5 (a) contributing to the assessment of the health status of individuals and groups;
6 (b) participating in the development and modification of the strategy of care;
7 (c) implementing appropriate aspects of the strategy of care;
8 (d) maintaining safe and effective nursing care rendered to a patient directly or indirectly;
9 and
10 (e) participating in the evaluation of responses to interventions.
11 (13) "Practice of registered nursing" means performing acts of nursing as provided in this
12 Subsection (13) by a person licensed under this chapter as a registered nurse within the generally
13 recognized scope of practice of registered nurses as defined by rule. Registered nursing acts
14 include:
15 (a) assessing the health status of individuals and groups;
16 (b) identifying health care needs;
17 (c) establishing goals to meet identified health care needs;
18 (d) planning a strategy of care;
19 (e) prescribing nursing interventions to implement the strategy of care;
20 (f) implementing the strategy of care;
21 (g) maintaining safe and effective nursing care that is rendered to a patient directly or
22 indirectly;
23 (h) evaluating responses to interventions;
24 (i) teaching the theory and practice of nursing; and
25 (j) managing and supervising the practice of nursing.
26 (14) "Practice of advanced practice registered nursing" means the practice of nursing
27 within the generally recognized scope and standards of advanced practice registered nursing as
28 defined by rule and consistent with professionally recognized preparation and education standards
29 of an advanced practice registered nurse by a person licensed under this chapter as an advanced
30 practice registered nurse. Advanced practice registered nursing includes:
31 (a) maintenance and promotion of health and prevention of disease;

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1 (b) diagnosis, treatment, correction, consultation, and referral for common health
2 problems; and
3 (c) prescription or administration of prescription drugs or devices including:
4 (i) local anesthesia;
5 (ii) schedule IV-V controlled substances; and
6 (iii) schedule II-III controlled substances in accordance with a consultation and referral
7 plan.
8 (15) "Unlawful conduct" is as defined in Sections 58-1-501 and 58-31b-501.
9 (16) "Unlicensed assistive personnel" means any unlicensed person, regardless of title, to
10 whom tasks are delegated by a licensed nurse as permitted by rule and in accordance with the
11 standards of the profession.
12 (17) "Unprofessional conduct" is as defined in Sections 58-1-501 and 58-31b-502 and as
13 may be further defined by rule.
14 Section 6. Section 58-31b-103 is enacted to read:
15 58-31b-103. Education and enforcement fund.
16 (1) There is created within the General Fund a restricted account known as the "Nurse
17 Education and Enforcement Fund."
18 (2) The account shall be nonlapsing and consist of:
19 (a) administrative penalties imposed under Section 58-31b-402; and
20 (b) interest earned on monies in the account.
21 (3) Monies in the account may be appropriated by the Legislature for the following
22 purposes:
23 (a) education and training of licensees under this chapter;
24 (b) enforcement of this chapter by:
25 (i) investigating unprofessional or unlawful conduct;
26 (ii) providing legal representation to the division when legal action is taken against a
27 person engaging in unprofessional or unlawful conduct; and
28 (iii) monitoring compliance of renewal requirements;
29 (c) survey nursing education programs throughout the state; and
30 (d) education and training of board members.
31 Section 7. Section 58-31b-201 is enacted to read:

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1 Part 2. Board
2 58-31b-201. Board.
3 (1) There is created the Board of Nursing that consists of the following 13 members,
4 whose appointments shall provide broad representation of the various interests and constituencies
5 in the nursing profession:
6 (a) six persons licensed as registered nurses:
7 (i) three of whom are actively involved in approved nursing education programs and
8 represent various types of education programs; and
9 (ii) one of whom is employed in a nursing administrative position within a licensed health
10 care facility;
11 (b) two persons licensed as licensed practical nurses;
12 (c) three persons licensed as advanced practice registered nurses or certified registered
13 nurse anesthetists, one of whom also holds a controlled substance license; and
14 (d) two members of the public who are not licensed health care providers.
15 (2) The board shall be appointed and serve in accordance with Section 58-1-201.
16 (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
17 58-1-203 and shall:
18 (a) (i) recommend to the division minimum standards for educational programs qualifying
19 a person for licensure under this chapter;
20 (ii) recommend to the division denial, approval, or withdrawal of approval regarding
21 educational programs that meet or fail to meet the established minimum standards; and
22 (iii) designate one of its members on a permanent or rotating basis to:
23 (A) assist the division in reviewing complaints concerning the unlawful or unprofessional
24 conduct of a licensee; and
25 (B) advise the division in its investigation of these complaints.
26 (b) A board member who has, under Subsection (3)(a), reviewed a complaint or advised
27 in its investigation may be disqualified from participating with the board when the board serves
28 as a presiding officer in an adjudicative proceeding concerning the complaint.
29 (4) (a) The director shall appoint an individual to serve as the executive administrator of
30 the Board of Nursing. Except when the board serves as a presiding officer in an adjudicative
31 procedure, the executive administrator shall serve as an ex officio member of the board and shall

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1 represent the position of the division in matters considered by the board.
2 (b) The executive administrator shall be a licensed registered nurse, shall have earned a
3 masters degree in nursing, and shall have a minimum of five years of experience working in
4 nursing administration or nursing education.
5 Section 8. Section 58-31b-202 is enacted to read:
6 58-31b-202. Prescriptive Practice Peer Committee.
7 (1) (a) There is created under Subsection 58-1-203(6) the Prescriptive Practice Peer
8 Committee.
9 (b) The Prescriptive Practice Peer Committee shall:
10 (i) advise the board of nursing regarding prescriptive practice issues;
11 (ii) periodically audit and review the prescribing records of advanced practice registered
12 nurses located on the Controlled Substance Data Bank on a schedule established by rule;
13 (iii) recommend the scope of prescriptive practice authority of advanced practice registered
14 nurses consistent with this chapter and with professionally accepted therapies and treatments;
15 (iv) periodically review the current consultation and referral plans prepared in accordance
16 with Subsection 58-31b-102(14)(c)(iii) and evaluate compliance with the proposed plans; and
17 (v) recommend disciplinary action.
18 (c) The composition of this committee shall be:
19 (i) two individuals who are licensed as advanced practice registered nurses who prescribe
20 within their practice and possess a controlled substance license;
21 (ii) two individuals licensed as physicians and surgeons or osteopathic physicians and
22 surgeons; and
23 (iii) one individual who is a pharmacologist.
24 (2) The division, in collaboration with the board, may create other peer committees to the
25 Board of Nursing pursuant to Subsection 58-1-203(6) to make recommendations to the board
26 regarding licensure, practice, and education issues.
27 Section 9. Section 58-31b-301 is enacted to read:
28 Part 3. Licensing
29 58-31b-301. License required - License classifications.
30 (1) A license is required to engage in the practice of nursing, except as specifically
31 provided in Sections 58-1-307 and 58-31b-308.

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1 (2) The division shall issue to a person who qualifies under this chapter a license in the
2 classification of:
3 (a) licensed practical nurse;
4 (b) registered nurse;
5 (c) advanced practice registered nurse intern;
6 (d) advanced practice registered nurse; and
7 (e) certified registered nurse anesthetist.
8 (3) An individual holding an advanced practice registered nurse license as of July 1, 1998,
9 who cannot document the successful completion of advanced course work in patient assessment,
10 diagnosis and treatment, and pharmacotherapeutics, may not prescribe and shall be issued an
11 "APRN - without prescriptive practice" license.
12 (4) The division shall grant an advanced practice registered nurse license to any licensed
13 advanced practice registered nurse currently holding prescriptive authority under any predecessor
14 act on July 1, 1998.
15 Section 10. Section 58-31b-302 is enacted to read:
16 58-31b-302. Qualifications for licensure.
17 (1) An applicant for licensure as a licensed practical nurse shall:
18 (a) submit to the division an application in a form prescribed by the division;
19 (b) pay to the division a fee determined under Section 63-38-3.2;
20 (c) have a high school diploma or its equivalent;
21 (d) be in a condition of physical and mental health that will permit the applicant to practice
22 safely as a licensed practical nurse;
23 (e) have completed an approved practical nursing education program or an equivalent as
24 determined by the board;
25 (f) have passed the examinations prescribed by division rule made in collaboration with
26 the board within two years after completion of the approved practical nursing education program
27 required under Subsection (1)(e) and within three years of the date of application for a Utah
28 license; and
29 (g) meet with the board, if requested, to determine the applicant's qualifications for
30 licensure.
31 (2) An applicant for licensure as a registered nurse shall:

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1 (a) submit to the division an application form prescribed by the division;
2 (b) pay to the division a fee determined under Section 63-38-3.2;
3 (c) have a high school diploma or its equivalent;
4 (d) be in a condition of physical and mental health that will allow the applicant to practice
5 safely as a registered nurse;
6 (e) have completed an approved registered nursing education program;
7 (f) have passed the examinations prescribed by division rule made in collaboration with
8 the board within two years after completion of the approved registered nursing education program
9 required under Subsection (2)(e) and within three years of the date of application for a Utah
10 license; and
11 (g) meet with the board, if requested, to determine the applicant's qualifications for
12 licensure.
13 (3) Applicants for licensure as an advanced practice registered nurse shall:
14 (a) submit to the division an application on a form prescribed by the division;
15 (b) pay to the division a fee determined under Section 63-38-3.2;
16 (c) be in a condition of physical and mental health which will allow the applicant to
17 practice safely as an advanced practice registered nurse;
18 (d) hold a current registered nurse license in good standing issued by the state or be
19 qualified at the time for licensure as a registered nurse;
20 (e) have earned a graduate degree in nursing or a related area of specialized knowledge as
21 determined appropriate by the division in collaboration with the board;
22 (f) have completed course work in patient assessment, diagnosis and treatment, and
23 pharmacotherapeutics from an education program approved by the division in collaboration with
24 the board;
25 (g) have successfully completed clinical practice in psychiatric and mental health nursing,
26 including psychotherapy as defined by division rule, after completion of the masters degree
27 required for licensure, to practice within the psychiatric and mental health nursing specialty;
28 (h) have passed the examinations prescribed by division rule made in collaboration with
29 the board within two years after completion of the approved education program required under
30 Subsection (3)(f);
31 (i) be currently certified by a program approved by the division in collaboration with the

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1 board and submit evidence satisfactory to the division of the certification; and
2 (j) meet with the board, if requested, to determine the applicant's qualifications for
3 licensure.
4 (4) An applicant for licensure as a certified registered nurse anesthetist shall:
5 (a) submit to the division an application on a form prescribed by the division;
6 (b) pay to the division a fee determined under Section 63-38-3.2;
7 (c) be in a condition of physical and mental health which will allow the applicant to
8 practice safely as a certified registered nurse anesthetist;
9 (d) hold a current registered nurse license in good standing issued by the state or be
10 qualified at the time for licensure as a registered nurse;
11 (e) complete a nurse anesthesia program which is approved by the Council on
12 Accreditation of Nurse Anesthesia Educational Programs;
13 (f) be currently certified by a program approved by the division in collaboration with the
14 board and submit evidence satisfactory to the division of the certification; and
15 (g) meet with the board, if requested, to determine the applicant's qualifications for
16 licensure.
17 Section 11. Section 58-31b-303 is enacted to read:
18 58-31b-303. Qualifications for licensure -- Graduates of nonapproved nursing
19 programs.
20 An applicant for licensure as a practical nurse or registered nurse who is a graduate of a
21 nursing education program not approved by the division in collaboration with the board must
22 comply with the requirements of this section.
23 (1) An applicant for licensure as a licensed practical nurse shall:
24 (a) meet all requirements of Subsection 58-31b-302(1), except Subsection (1)(e); and
25 (b) produce evidence acceptable to the division and the board that the nursing education
26 program completed by the applicant is equivalent to the minimum standards established by the
27 division in collaboration with the board for an approved licensed practical nursing education
28 program.
29 (2) An applicant for licensure as a registered nurse shall:
30 (a) meet all requirements of Subsection 58-31b-302(2), except Subsection (2)(e); and
31 (b) (i) pass the Commission on Graduates of Foreign Nursing Schools (CGFNS)

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1 Examination; or
2 (ii) produce evidence acceptable to the division and the board that the applicant is
3 currently licensed as a registered nurse in one of the states, territories, or the District of Columbia
4 of the United States and has practiced satisfactorily as a licensed registered nurse in that
5 jurisdiction for a period of not less than 4,000 hours.
6 Section 12. Section 58-31b-304 is enacted to read:
7 58-31b-304. Qualifications for admission to the examinations.
8 (1) To be admitted to the examinations required for licensure as a practical nurse, a person
9 shall:
10 (a) submit an application form prescribed by the division;
11 (b) pay a fee as determined by the division under Section 63-38-3.2; and
12 (c) meet all requirements of Subsection 58-31b-302(1), except Subsection (1)(f).
13 (2) To be admitted to the examinations required for licensure as a registered nurse, a
14 person shall:
15 (a) submit an application form prescribed by the division;
16 (b) pay a fee as determined by the division under Section 63-38-3.2; and
17 (c) meet all the requirements of Subsection 58-31b-302(2), except Subsection (2)(f).
18 Section 13. Section 58-31b-305 is enacted to read:
19 58-31b-305. Term of license -- Expiration -- Renewal.
20 (1) The division shall issue each license under this chapter in accordance with a two-year
21 renewal cycle established by rule. The division may by rule extend or shorten a renewal period
22 by as much as one year to stagger the renewal cycles it administers.
23 (2) At the time of renewal, the licensee shall show satisfactory evidence of each of the
24 following renewal requirements:
25 (a) complete and submit an application for renewal in a form prescribed by the division
26 and pay the renewal fee determined under Section 63-38-3.2; and
27 (b) meet continuing competency requirements as established by rule.
28 (3) In addition to the renewal requirements under Subsection (2), a person licensed as a
29 advanced practice registered nurse shall:
30 (a) be currently certified by a program approved by the division in collaboration with the
31 board and submit evidence satisfactory to the division of that qualification; and

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1 (b) as a condition precedent for license renewal commencing on and after July 1, 1999,
2 actively participate on a continuing basis in a quality review program based on criteria established
3 by the division by rule in collaboration with the board. A quality review program shall be:
4 (i) based in a hospital or other licensed health care facility, as defined in Section 26-21-2,
5 at which the licensee regularly engages in practice; or
6 (ii) conducted by or under the direction of:
7 (A) a professional association approved by the division in collaboration with the board;
8 or
9 (B) another organization approved by the division in collaboration with the board as
10 defined by division rule.
11 (4) In addition to the renewal requirements under Subsection (2), a person licensed as a
12 certified registered nurse anesthetists shall:
13 (a) actively participate on a continuing regular basis in an anesthesia quality assurance
14 program approved by the division in collaboration with the board and submit evidence satisfactory
15 to the division of the participation; and
16 (b) be currently certified in anesthesia by a program approved by the division in
17 collaboration with the board and submit evidence satisfactory to the division of the certification.
18 (5) Each license automatically expires on the expiration date shown on the license unless
19 renewed in accordance with Section 58-1-308.
20 Section 14. Section 58-31b-306 is enacted to read:
21 58-31b-306. APRN intern license.
22 (1) (a) The division may issue an APRN intern license to a person who meets all
23 qualifications for a license as an advanced practice registered nurse under this chapter, except for
24 the passing of required examinations, if the applicant:
25 (i) is a graduate of an approved nursing education program within the year immediately
26 preceding application for an intern license;
27 (ii) has never before taken the examinations; and
28 (iii) submits to the division evidence of having secured employment conditioned upon
29 issuance of the APRN intern license, and the employment is under the supervision of an advanced
30 practice registered nurse or physician as defined by division rule.
31 (b) An APRN intern license issued under Subsection (1)(a) expires on the earlier of:

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1 (i) a date following a period established by division rule;
2 (ii) the date upon which the division receives notice from the examination agency that the
3 individual failed to take or pass the examinations upon notification to the applicant; or
4 (iii) the date upon which the division issues the individual an APRN license.
5 (2) An applicant specializing in psychiatric mental health nursing may be issued an APRN
6 intern license upon completion of all licensure requirements, except for the passing of required
7 examinations and completion of required clinical practice hours.
8 (3) (a) The division may issue an APRN intern license to a person who meets all
9 qualifications for a license as an advanced practice registered nurse under this chapter, except
10 course work in patient assessment or pharmacotherapeutics, if that applicant:
11 (i) is licensed in good standing as an advanced practice registered nurse in another state
12 or jurisdiction; and
13 (ii) submits to the division evidence of having secured employment conditioned upon
14 issuance of the APRN intern license, and the employment is under the supervision of an advanced
15 practice registered nurse or physician as defined by division rule.
16 (b) An APRN intern license issued under Subsection (3)(a) expires on the earlier of:
17 (i) a date following a period established by division rule; or
18 (ii) the date upon which the division issues the individual a regular license.
19 Section 15. Section 58-31b-307 is enacted to read:
20 58-31b-307. Licensure by endorsement.
21 An applicant for licensure by endorsement as an advanced practice registered nurse under
22 the provisions of Section 58-1-302 shall also:
23 (1) demonstrate that the applicant has successfully engaged in active practice as an
24 advanced practice registered nurse for not less than 1,500 hours per year in not less than three of
25 the past five years immediately preceding the application for licensure; and
26 (2) demonstrate that the applicant has completed course work as required in Subsection
27 58-31b-302(3)(f).
28 Section 16. Section 58-31b-308 is enacted to read:
29 58-31b-308. Exemptions from licensure.
30 In addition to the exemptions from licensure in Section 58-1-307, the following persons
31 may engage in acts included within the definition of the practice of nursing, subject to the stated

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1 circumstances and limitations, without being licensed under this chapter:
2 (1) friends, family members, foster parents, or legal guardians of a patient performing
3 gratuitous nursing care for the patient;
4 (2) persons providing care in a medical emergency;
5 (3) persons engaged in the practice of religious tenets of a church or religious
6 denomination; and
7 (4) persons engaged in the practice of nursing under any interstate agreements or multistate
8 licensure as defined by division rule.
9 Section 17. Section 58-31b-309 is enacted to read:
10 58-31b-309. Continuing education.
11 (1) The division in collaboration with the board may establish continuing education
12 requirements for each classification of nurse licensure.
13 (2) The division may discriminate between classifications of licensure with respect to
14 continuing education requirements upon finding the continuing education requirements are
15 necessary to reasonably protect the public health, safety, or welfare.
16 Section 18. Section 58-31b-401 is enacted to read:
17 Part 4. License Denial and Discipline
18 58-31b-401. Grounds for denial of licensure and disciplinary proceedings.
19 (1) Grounds for refusal to issue a license to an applicant, for refusal to renew the license
20 of a licensee, to revoke, suspend, restrict, or place on probation the license of a licensee, to issue
21 a public or private reprimand to a licensee, and to issue cease and desist orders shall be in
22 accordance with Section 58-1-401.
23 (2) (a) If a court of competent jurisdiction determines that a nurse is an "incapacitated
24 person" as defined in Section 75-1-201 h [ or is mentally ill ] h , the director shall suspend the license of
25 the nurse upon entry of the judgment, regardless of the pendency of an appeal.
26 (b) If it appears to the board that there is reasonable cause to believe that a nurse, even
27 though the nurse has not been judicially determined to be incompetent, mentally incompetent, or
28 incapable, is unable to practice nursing with reasonable skill and safety to patients because of
29 illness, drunkenness, excessive use of drugs, narcotics, chemical, or any other type of material, or
30 as a result of any mental or physical condition, a complaint in the name of the board shall be
31 served upon the nurse for hearing on the sole issue of the capacity of the nurse to conduct properly
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lilac-February 20, 1998

1 the practice of nursing.
2 (c) (i) Failure of a nurse to submit to a mental or physical examination within 30 days
3 when directed by the board in connection with a hearing instituted under Subsection (2)(b)
4 constitutes grounds for immediate suspension of the nurse's license, unless the failure was due to
5 circumstances beyond the control of the nurse.
6 (ii) A licensee who submits to an examination under this Subsection (2) waives all
7 objections to the admissibility of an examining physician's testimony or examination report on the
8 ground that they constitute a privileged communication.
9 (iii) The director may enter an order of suspension of the license without the taking of
10 testimony or the presentation of evidence upon a finding of reasonable cause to believe that an
11 order of suspension is necessary to protect the public health, safety, or welfare, if a hearing is
12 scheduled to occur within 30 days of the order of suspension.
13 (d) A nurse whose license is suspended under Subsection (2) shall, at reasonable intervals
14 defined by rule, be afforded the opportunity to demonstrate that the nurse can resume the
15 competent practice of nursing with reasonable skill and safety to patients.
16 Section 19. Section 58-31b-402 is enacted to read:
17 58-31b-402. Authority to assess penalty.
18 (1) After a proceeding pursuant to Title 63, Chapter 46b, Administrative Procedures Act,
19 and Title 58, Chapter 1, Division of Occupational and Professional Licensing Act, the division
20 may impose an administrative penalty of up to $10,000 for unprofessional or unlawful conduct
21 under this chapter in accordance with a fine schedule established by rule.
22 (2) The assessment of a penalty under this section does not affect any other action the
23 division is authorized to take regarding a license issued under this chapter.
24 (3) The division may impose an administrative penalty of up to $500 for any violation of
25 Subsection 58-31b-501(1) or (2), consistent with Section 58-31b-503.
26 Section 20. Section 58-31b-501 is enacted to read:
27 Part 5. Unlawful and Unprofessional Conduct - Penalties
28 58-31b-501. Unlawful conduct.
29 "Unlawful conduct" includes:
30 (1) using the following titles, names or initials, if the user is not properly licensed under
31 this chapter:

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1 (a) nurse;
2 (b) licensed practical nurse, practical nurse, or L.P.N.;
3 (c) registered nurse or R.N.;
4 (d) registered nurse practitioner, N.P., or R.N.P.;
5 (e) registered nurse specialist, N.S., or R.N.S.;
6 (f) registered psychiatric mental health nurse specialist;
7 (g) advanced practice registered nurse;
8 (h) nurse anesthetist, certified nurse anesthetist, certified registered nurse anesthetist, or
9 C.R.N.A.; or
10 (i) other generally recognized names or titles used in the profession of nursing;
11 (2) using any other name, title, or initials that would cause a reasonable person to believe
12 the user is licensed under this chapter if the user is not properly licensed under this chapter; and
13 (3) conducting a nursing education program in the state for the purpose of qualifying
14 individuals to meet requirements for licensure under this chapter without the program having been
15 approved under Section 58-31b-601.
16 Section 21. Section 58-31b-502 is enacted to read:
17 58-31b-502. Unprofessional conduct.
18 "Unprofessional conduct" includes:
19 (1) failure to safeguard a patient's right to privacy as to the patient's person, condition,
20 diagnosis, personal effects, or any other matter about which the licensee is privileged to know
21 because of the licensee's position or practice as a nurse;
22 (2) failure to provide nursing service in a manner that demonstrates respect for the patient's
23 human dignity and unique personal character and needs without regard to the patient's race,
24 religion, ethnic background, socioeconomic status, age, sex, or the nature of the patient's health
25 problem;
26 (3) engaging in sexual relations with a patient during any:
27 (a) period when a generally recognized professional relationship exists between the nurse
28 and patient; or
29 (b) extended period when a patient has reasonable cause to believe a professional
30 relationship exists between the nurse and patient;
31 (4) (a) as a result of any circumstance under Subsection (3), exploiting or using

- 21 -

1 information about a patient or exploiting the licensee's professional relationship between the
2 licensee and the patient; or
3 (b) exploiting the patient by use of the licensee's knowledge of the patient obtained while
4 acting as a nurse;
5 (5) unlawfully obtaining, possessing, or using any prescription drug or illicit drug;
6 (6) unauthorized taking or personal use of nursing supplies from an employer;
7 (7) unauthorized taking or personal use of a patient's personal property;
8 (8) knowingly entering into any medical record any false or misleading information or
9 altering a medical record in any way for the purpose of concealing an act, omission, or record of
10 events, medical condition, or any other circumstance related to the patient and the medical or
11 nursing care provided;
12 (9) unlawful or inappropriate delegation of nursing care;
13 (10) failure to exercise appropriate supervision of persons providing patient care services
14 under supervision of the licensed nurse;
15 (11) employing or aiding and abetting the employment of an unqualified or unlicensed
16 person to practice as a nurse;
17 (12) failure to file or record any medical report as required by law, impeding or obstructing
18 the filing or recording of such a report, or inducing another to fail to file or record such a report;
19 (13) breach of a statutory, common law, regulatory or ethical requirement of
20 confidentiality with respect to a person who is a patient, unless ordered by a court;
21 (14) failure to pay a penalty imposed by the division; and
22 (15) prescribing a schedule II-III controlled substance without a consulting physician or
23 outside of a consultation and referral plan; and
24 (16) violating Section 58-31b-801.
25 Section 22. Section 58-31b-503 is enacted to read:
26 58-31b-503. Penalty for unlawful conduct.
27 (1) Any person who violates the unlawful conduct provision specifically defined in
28 Subsection 58-1-501(1)(a) is guilty of a third degree felony.
29 (2) Any person who violates any of the unlawful conduct provisions specifically defined
30 in Subsections 58-1-501(1)(b) through (e) and 58-31b-501(3) is guilty of a class A misdemeanor.
31 (3) Any person who violates any of the unlawful conduct provisions specifically defined

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1 in this chapter and not set forth in Subsection (1) or (2) is guilty of a class B misdemeanor.
2 (4) Subject to Subsection (5), the division may assess administrative penalties in
3 accordance with the provisions of Section 58-31b-402 for acts of unprofessional or unlawful
4 conduct or any other appropriate administrative action in accordance with the provisions of Section
5 58-31b-401.
6 (5) If a licensee has been convicted of violating Section 58-31b-501 prior to an
7 administrative finding of a violation of the same section, the licensee may not be assessed an
8 administrative penalty under this chapter for the same offense for which the conviction was
9 obtained.
10 Section 23. Section 58-31b-601 is enacted to read:
11 Part 6. Nursing Education Programs
12 58-31b-601. Minimum standards for nursing programs.
13 (1) A nursing education program shall be affiliated with an accredited institution of higher
14 education in order to be approved by the division.
15 (2) The minimum standards a nursing program shall meet to qualify graduates for
16 licensure under this chapter shall be defined by division rule.
17 Section 24. Section 58-31b-701 is enacted to read:
18 Part 7. Immunity Provisions
19 58-31b-701. Immunity from liability.
20 A person licensed under this chapter:
21 (1) who provides emergency care in accordance with Section 78-11-22 is entitled to the
22 immunity from civil liability provided under that section; and
23 (2) is considered a health care provider under Chapter 13, Health Care Providers Immunity
24 from Liability Act, and is entitled to the immunity from civil liability provided under that chapter.
25 Section 25. Section 58-31b-702 is enacted to read:
26 58-31b-702. Reporting of disciplinary action -- Immunity from liability.
27 (1) A licensed health care facility or organization or a professional society of nurses in the
28 state that takes disciplinary action against a person licensed under this chapter relating to any of
29 the following shall report the action in writing to the division within 30 days after the action is
30 taken:
31 (a) that person's professional acts or omissions as a licensed nurse;

- 23 -

1 (b) that person's nursing competence or ability to practice nursing safely; or
2 (c) that person's use of alcohol or drugs in an unlawful manner or to the extent the person
3 is impaired in his ability to practice nursing safely.
4 (2) Any person or organization furnishing information in accordance with this section is
5 immune from liability to the extent that the information is furnished in good faith and without
6 malice.
7 Section 26. Section 58-31b-801 is enacted to read:
8 Part 8. Practice Standards
9 58-31b-801. Practice within limits of competency.
10 (1) Each person licensed under this chapter is responsible for confining his practice as a
11 nurse to those acts and practices permitted by law.
12 (2) A person licensed under this act may not engage in any act or practice for which he is
13 not competent.
14 Section 27. Section 58-44a-102 is amended to read:
15 58-44a-102. Definitions.
16 In addition to the definitions in Section 58-1-102, as used in this chapter:
17 (1) "Administrative penalty" means a monetary fine imposed by the division for acts or
18 omissions determined to constitute unprofessional or unlawful conduct in accordance with a fine
19 schedule established by rule and as a result of an adjudicative proceeding conducted in accordance
20 with Title 63, Chapter 46b, Administrative Procedures Act.
21 [(1)] (2) "Board" means the [Registered Nurse] Certified Nurse Midwife Board created
22 in Section 58-44a-201.
23 (3) "Consultation and Referral Plan" means a written plan jointly developed by a certified
24 nurse midwife, as defined in Subsection (6), and a consulting physician that permits the certified
25 nurse midwife to prescribe schedule II-III controlled substances in consultation with the consulting
26 physician.
27 [(2)] (4) "Consulting physician" means a physician and surgeon or osteopathic physician:
28 (a) licensed as a physician [under Title 58, Chapter 67, Utah Medical Practice Act];
29 (b) qualified by education, training, and current practice in obstetrics, gynecology, or both
30 to act as a consulting physician to a nurse midwife practicing under this chapter[;] and providing
31 intrapartum care or prescribing Schedule II-III controlled substances; and

- 24 -

1 (c) who has agreed under a practice plan to be available to consult with a nurse midwife,
2 which plan does not include the consulting physician's being present at the time or place the nurse
3 midwife is engaged in practice[; and].
4 [(d) approved by the division and board to serve as a consulting physician.]
5 [(3)] (5) "Individual" means a natural person.
6 [(4)] (6) "Nurse midwife" means a person licensed under this chapter to engage in practice
7 as a [registered nurse] certified nurse midwife.
8 [(5)] (7) "Physician" means a physician and surgeon or osteopathic surgeon licensed under
9 Title 58, Chapter 67, Utah Medical Practice Act or Chapter 68, Utah Osteopathic Medical Practice
10 Act.
11 [(6)] (8) "Practice as a certified nurse midwife" means:
12 (a) practice as a registered nurse as defined in Section [58-31-2] 58-31b-102, and as
13 consistent with the education, training, experience, and current competency of the licensee; and
14 (b) practice [under a written practice plan approved by the division in collaboration with
15 the board, entered into with a consulting physician, and detailing guidelines by which the nurse
16 midwife may diagnose, treat, prescribe, consult, collaborate, and refer patients in] of nursing
17 within the generally recognized scope [of practice of a] and standards of nurse [midwife consistent
18 with standards published by the American College of Nurse-Midwives, set forth in this chapter,
19 and set forth in rules adopted by the division, which plan includes the authority to] midwifery as
20 defined by rule and consistent with professionally recognized preparations and educational
21 standards of a certified nurse midwife by a person licensed under this chapter, which practice
22 includes the authority to:
23 (i) elicit and record a patient's complete health information, including physical
24 examination, history, and laboratory findings commonly used in providing obstetrical,
25 gynecological, and well infant services to a patient;
26 (ii) assess findings and upon abnormal findings from the history, physical examination,
27 or laboratory findings, manage the treatment of the patient, collaborate with the consulting
28 physician or another qualified physician, or refer the patient to the consulting physician or to
29 another qualified physician as appropriate;
30 (iii) diagnose, plan, and implement appropriate patient care[;], including the administration
31 and prescribing of:

- 25 -

1 (A) prescription drugs;
2 (B) schedule IV-V controlled substances; and
3 (C) schedule II-III controlled substances in accordance with a consultation and referral
4 plan.
5 (iv) evaluate the results of patient care;
6 (v) consult as is appropriate regarding patient care and the results of patient care;
7 (vi) manage the intrapartum period according to accepted standards of nurse midwifery
8 practice and a written practice and referral plan, including performance of routine episiotomy and
9 repairs, and administration of anesthesia, including local, pudendal, or paracervical block
10 anesthesia, but not including general anesthesia and major conduction anesthesia;
11 (vii) manage the postpartum period;
12 (viii) provide gynecological services;
13 (ix) provide noncomplicated newborn and infant care to the age of one year; and
14 (x) represent or hold oneself out as a [registered nurse certified nurse midwife,] certified
15 nurse midwife, or nurse midwife, or use the title [registered nurse certified nurse midwife,]
16 certified nurse midwife, nurse midwife, or the initials [R.N.C.N.M.,] C.N.M., N.M., or R.N.
17 (9) "Practice and referral plan" means a written plan entered into with a consulting
18 physician and detailing guidelines by which a certified nurse midwife consults, collaborates, and
19 refers patients.
20 [(7)] (10) "Unlawful conduct" is defined in [Section] Sections 58-1-501 and [also
21 includes:] 58-44a-501.
22 [(a) engaging in practice as a nurse midwife when not licensed or exempted from licensure
23 under this chapter, or engaging in practice as a registered nurse when not licensed or exempted
24 from licensure under this chapter or Title 58, Chapter 31, Nurse Practice Act; and]
25 [(b) (i) representing or holding oneself out as a registered nurse certified nurse midwife,
26 certified nurse midwife, nurse midwife, or identifying oneself by the initials R.N.C.N.M., C.N.M.,
27 or N.M. when not licensed under this chapter;]
28 [(ii) representing or holding out oneself as a registered nurse or identifying oneself by the
29 initials R.N. when not licensed under this chapter or Title 58, Chapter 31; or]
30 [(iii) use of any other title, initials, or any other means indicating that one is licensed under
31 this chapter.]

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1 (11) "Unlicensed assistive personnel" means any unlicensed person, regardless of title, to
2 whom tasks are delegated by a licensed certified nurse midwife in accordance with the standards
3 of the profession as defined by rule.
4 [(8)] (12) "Unprofessional conduct" is defined in [Section] Sections 58-1-501 and [also
5 includes:] 58-44a-502 and as may be further defined by rule.
6 [(a) any unlawful act, omission, or practice as a nurse midwife;]
7 [(b) failure to practice in accordance with accepted standards and ethics of the profession;]
8 [(c) disregard for a patient's dignity or right to privacy as to her person, condition,
9 possessions, or medical record;]
10 [(d) verbally or physically abusing a patient;]
11 [(e) engaging in an act, practice, or omission which when considered with the duties and
12 responsibilities of a nurse midwife does or could jeopardize the health, safety, or welfare of a
13 patient or the public;]
14 [(f) failure to confine one's practice as a nurse midwife to those acts or practices permitted
15 by law;]
16 [(g) engaging in any act or practice as a nurse midwife in which one is not competent by
17 education, preparation, experience, or physical or mental condition; or]
18 [(h) acts, practices, or omissions which result in the individual's license to practice in any
19 health care profession in Utah or any other jurisdiction being subjected to disciplinary action.]
20 Section 28. Section 58-44a-103 is enacted to read:
21 58-44a-103. Education and enforcement fund.
22 (1) There is created within the General Fund a restricted account known as the "Certified
23 Nurse Midwife Education and Enforcement Fund."
24 (2) The account shall be nonlapsing and consist of:
25 (a) administrative penalties imposed under Section 58-44a-402; and
26 (b) interest earned on monies in the account.
27 (3) Monies in the account may be appropriated by the Legislature for the following
28 purposes:
29 (a) education and training of licensees under this chapter;
30 (b) enforcement of this chapter by:
31 (i) investigating unprofessional or unlawful conduct;

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1 (ii) providing legal representation to the division when legal action is taken against a
2 person engaging in unprofessional or unlawful conduct; and
3 (iii) monitoring compliance of renewal requirements; and
4 (c) education and training of board members.
5 Section 29. Section 58-44a-201 is amended to read:
6 58-44a-201. Board.
7 (1) There is created the [Registered Nurse] Certified Nurse Midwife Board consisting of
8 four certified nurse midwives and one member representing the general public.
9 (2) The board shall be appointed and serve in accordance with Section 58-1-201.
10 (3) The duties and responsibilities of the board are in accordance with Sections 58-1-202
11 and 58-1-203, and the board shall also:
12 (a) designate one of its members on a permanent or rotating basis to assist the division in
13 reviewing complaints concerning the unlawful or unprofessional practice of a certified nurse
14 midwife[,]; and [to]
15 (b) advise the division [regarding] in its investigation of these complaints[; and].
16 [(b) disqualify any board member from participating as a member of the board in his
17 capacity as a presiding officer in any administrative procedure in which that member has
18 previously reviewed the complaint or advised the division.]
19 (4) A board member who has, under Subsection (3), reviewed a complaint or advised in
20 its investigation may be disqualified from participating with the board when the board serves as
21 a presiding officer in an adjudicative proceeding concerning the complaint.
22 Section 30. Section 58-44a-301 is amended to read:
23 58-44a-301. Licensure required -- License classification.
24 (1) A license is required to engage in practice as a certified nurse midwife, except as
25 provided in Section 58-1-307.
26 (2) The division shall issue to individuals qualified under the provisions of this chapter
27 a license in the classification [registered nurse] certified nurse midwife.
28 (3) An individual holding a certified nurse midwife license as of July 1, 1998, who cannot
29 document the successful completion of advanced course work approved by the division in
30 collaboration with the board in patient assessment, diagnosis and treatment, and
31 pharmacotherapeutics, may not prescribe and shall be issued a "CNM without prescriptive

- 28 -

1 practice" license.
2 (4) The division shall grant a certified nurse midwife license to any licensed certified nurse
3 midwife currently holding prescriptive authority under any predecessor act on July 1, 1998.
4 Section 31. Section 58-44a-302 is amended to read:
5 58-44a-302. Qualifications for licensure.
6 An applicant for licensure as a nurse midwife shall:
7 (1) submit an application in a form as prescribed by the division;
8 (2) pay a fee as determined by the department under Section 63-38-3.2;
9 (3) be of good moral character;
10 (4) at the time of application for licensure hold a license in good standing as a registered
11 nurse in Utah, or be at that time qualified for a license as a registered nurse under Title 58, Chapter
12 31b, Nurse Practice Act;
13 (5) have completed:
14 (a) a certified nurse midwifery education program accredited by the American College of
15 Nurse Midwives and approved by the division; or
16 (b) have completed a nurse midwifery education program located outside of the United
17 States which is approved by the division and is equivalent to a program accredited by the
18 American College of Nurse Midwives, as demonstrated by a graduate's being accepted to sit for
19 the national certifying examination administered by the American College of Nurse Midwives
20 h [ Certification Council, Inc.; and ] OR ITS DESIGNEE; AND h
21 (6) have passed examinations established by the division rule in collaboration with the
22 board within two years after completion of the approved education program required under
23 Subsection (5).
24 Section 32. Section 58-44a-303 is amended to read:
25 58-44a-303. Term of license -- Expiration -- Renewal.
26 (1) (a) Each license issued under this chapter shall be issued in accordance with a two-year
27 renewal cycle established by rule.
28 (b) A renewal period may be extended or shortened by as much as one year to maintain
29 established renewal cycles or to change an established renewal cycle.
30 (2) At the time of renewal, the licensee shall:
31 (a) hold a valid certification from the American College of Nurse Midwives Certification
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lilac-February 20, 1998

1 Council Inc.; [and]
2 (b) have met continuing competency requirements defined by the division rule in
3 collaboration with the board[.]; and
4 (c) as a condition precedent for license renewal commencing on and after July 1, 1999,
5 actively participate on a continuing basis in a quality review program based on criteria established
6 by the division by rule in collaboration with the board. A quality review program shall be:
7 (i) based in a hospital or other licensed health care facility, as defined in Section 26-21-2,
8 at which the licensee regularly engages in practice; or
9 (ii) conducted by or under the direction of:
10 (A) a professional association approved by the division in collaboration with the board;
11 or
12 (B) another organization approved by the division in collaboration with the board as
13 defined by division rule.
14 Section 33. Section 58-44a-305 is amended to read:
15 58-44a-305. Intern license.
16 (1) The division may issue [a temporary] an intern license to an individual who meets all
17 qualifications for licensure except the passing of the qualifying examination if the applicant:
18 (a) graduated from an approved education program within the 12 months immediately
19 preceding the application for licensure;
20 (b) has never before taken the qualifying examination;
21 (c) is registered to take the next qualifying examination; and
22 (d) presents a plan acceptable to the division and board under which the applicant will
23 practice under any [temporary] intern license issued only under the direct supervision of a nurse
24 midwife or physician.
25 (2) [A temporary] An intern license issued under this section expires on:
26 (a) the date of the next qualifying examination immediately following issuance of the
27 [temporary] intern license if the [temporary] intern license holder does not sit for that examination;
28 (b) the date the examination results are available if the [temporary] intern license holder
29 sits for the next succeeding qualifying examination and fails the examination; or
30 (c) the date on which a regular license is issued if the [temporary] intern license holder
31 passes the examination and is otherwise qualified for licensure.

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1 Section 34. Section 58-44a-402 is enacted to read:
2 58-44a-402. Authority to assess penalty.
3 (1) After a proceeding pursuant to Title 63, Chapter 46b, Administrative Procedures Act,
4 and Title 58, Chapter 1, Division of Occupational and Professional Licensing Act, the division
5 may impose an administrative penalty of up to $10,000 for unprofessional or unlawful conduct
6 under this chapter in accordance with a fine schedule established by rule.
7 (2) The assessment of a penalty under this section does not affect any other action the
8 division is authorized to take regarding a license issued under this chapter.
9 (3) The division may impose an administrative penalty of up to $500 for any violation of
10 Subsection 58-44a-501(2), (3), or (4), consistent with Section 58-44a-503.
11 Section 35. Section 58-44a-501 is repealed and reenacted to read:
12 58-44a-501. Unlawful conduct.
13 "Unlawful conduct" includes:
14 (1) engaging in practice as a certified nurse midwife when not licensed or exempted from
15 licensure under this chapter, or engaging in practice as a registered nurse when not licensed or
16 exempted from licensure under this chapter or Title 58, Chapter 31b, Nurse Practice Act;
17 (2) representing or holding oneself out as a certified nurse midwife, nurse midwife, or
18 identifying oneself by the initials C.N.M. or N.M. when not licensed under this chapter;
19 (3) representing or holding out oneself as a registered nurse or identifying oneself by the
20 initials R.N. when not licensed under this chapter or Title 58, Chapter 31b, Nurse Practice Act;
21 and
22 (4) using any other title, initials, or any other means indicating that one is licensed under
23 this chapter.
24 Section 36. Section 58-44a-502 is enacted to read:
25 58-44a-502. Unprofessional conduct.
26 "Unprofessional conduct" includes:
27 (1) disregard for a patient's dignity or right to privacy as to his person, condition,
28 possessions, or medical record;
29 (2) engaging in an act, practice, or omission which when considered with the duties and
30 responsibilities of a certified nurse midwife does or could jeopardize the health, safety, or welfare
31 of a patient or the public;

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1 (3) failure to confine one's practice as a certified nurse midwife to those acts or practices
2 permitted by law;
3 (4) failure to file or record any medical report as required by law, impeding or obstructing
4 the filing or recording of such a report, or inducing another to fail to file or record such a report;
5 (5) breach of a statutory, common law, regulatory, or ethical requirement of confidentiality
6 with respect to a person who is a patient, unless ordered by the court;
7 (6) failure to pay a penalty imposed by the division; and
8 (7) prescribing a schedule II-III controlled substance without a consulting physician.
9 Section 37. Section 58-44a-503 is enacted to read:
10 58-44a-503. Penalty for unlawful conduct.
11 (1) Any individual who violates the unlawful conduct provisions of Subsection
12 58-44a-501(1) is guilty of a third degree felony.
13 (2) Any individual who violates the unlawful conduct provisions of Subsection
14 58-44a-501(2), (3), or (4) is guilty of a class A misdemeanor.
15 (3) Subject to Subsection (4), the division may assess administrative penalties in
16 accordance with the provisions of Section 58-44a-402 for acts of unprofessional or unlawful
17 conduct, or any other appropriate administrative action in accordance with the provisions of
18 58-44a-401.
19 (4) If a licensee has been convicted of violating Section 58-44a-501 prior to an
20 administrative finding of a violation of the same section, the licensee may not be assessed a
21 administrative penalty under this chapter for the same offense for which the conviction was
22 obtained.
23 Section 38. Section 58-44a-601 is repealed and reenacted to read:
24 Part 6. Delivery by Parents
25 58-44a-601. Parents delivering their children.
26 This chapter does not abridge, limit, or change in any way the right of parents to deliver
27 their baby where, when, how, and with whom they choose, regardless of licensure under this
28 chapter.
29 Section 39. Section 75-5-311 is amended to read:
30 75-5-311. Who may be guardian -- Priorities.
31 (1) As used in this section:

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1 (a) "Specialized care professional" means a person who:
2 (i) has been certified or designated as a provider of guardianship services by a nationally
3 recognized guardianship accrediting organization;
4 (ii) is licensed by or registered with the Division of Occupational and Professional
5 Licensing as a health care provider including, but not limited to, a registered nurse licensed under
6 Section [58-31-9] 58-31b-301, a social service worker, certified social worker, or clinical social
7 worker licensed under Section 58-60-205, a marriage and family therapist licensed under Section
8 58-60-305, a physician licensed under Title 58, Chapter 67, or a psychologist licensed under Title
9 58, Chapter 61; or
10 (iii) has been approved by the court as one with specialized training and experience in the
11 care of incapacitated persons.
12 (b) "Suitable institution" means any nonprofit or for profit corporation, partnership, sole
13 proprietorship, or other type of business organization that is owned, operated by, or employs a
14 specialized care professional.
15 (2) Any competent person or suitable institution may be appointed guardian of an
16 incapacitated person.
17 (3) The court shall appoint a guardian in accordance with the incapacitated person's most
18 recent nomination, unless that person is disqualified or the court finds other good cause why the
19 person should not serve as guardian. That nomination shall have been made prior to the person's
20 incapacity, shall be in writing and shall be signed by the person making the nomination. The
21 nomination shall be in substantially the following form:
22 Nomination of Guardian by an Adult
23 I, (Name), being of sound mind and not acting under duress, fraud, or other undue
24 influence, do hereby nominate (Name, current residence, and relationship, if any, of the nominee)
25 to serve as my guardian in the event that after the date of this instrument I become incapacitated.
26 Executed at ____________________________ (city, state)
27 on this ____________ day of ______________
28 ____________________________________
29 (Signature)
30 (4) Except as provided in Subsection (3), persons who are not disqualified have priority
31 for appointment as guardian in the following order:

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1 (a) a person who has been nominated by the incapacitated person, by any means other than
2 that described in Subsection (3), if the incapacitated person was 14 years of age or older when the
3 nomination was executed and, in the opinion of the court, that person acted with sufficient mental
4 capacity to make the nomination;
5 (b) the spouse of the incapacitated person;
6 (c) an adult child of the incapacitated person;
7 (d) a parent of the incapacitated person, including a person nominated by will, written
8 instrument, or other writing signed by a deceased parent;
9 (e) any relative of the incapacitated person with whom he has resided for more than six
10 months prior to the filing of the petition;
11 (f) a person nominated by the person who is caring for him or paying benefits to him; or
12 (g) a specialized care professional, so long as the specialized care professional does not:
13 (i) profit financially or otherwise from or receive compensation for acting in that capacity,
14 except for the direct costs of providing guardianship or conservatorship services; or
15 (ii) otherwise have a conflict of interest in providing those services.
16 Section 40. Section 78-14-3 is amended to read:
17 78-14-3. Definitions.
18 As used in this chapter:
19 (1) "Audiologist" means a person licensed to practice audiology under Title 58, Chapter
20 41, Speech-language Pathology and Audiology Licensing Act.
21 (2) "Certified social worker" means a person licensed to practice as a certified social
22 worker under Section 58-60-305.
23 (3) "Chiropractic physician" means a person licensed to practice chiropractic under Title
24 58, Chapter 73, Chiropractic Physician Practice Act.
25 (4) "Clinical social worker" means a person licensed to practice as a clinical social worker
26 under Section 58-60-305.
27 (5) "Commissioner" means the commissioner of insurance as provided in Section
28 31A-2-102.
29 (6) "Dental hygienist" means a person licensed to practice dental hygiene as defined in
30 Section 58-69-102.
31 (7) "Dentist" means a person licensed to practice dentistry as defined in Section

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1 58-69-102.
2 (8) "Division" means the Division of Occupational and Professional Licensing created in
3 Section 58-1-103.
4 (9) "Future damages" includes damages for future medical treatment, care or custody, loss
5 of future earnings, loss of bodily function, or future pain and suffering of the judgment creditor.
6 (10) "Health care" means any act or treatment performed or furnished, or which should
7 have been performed or furnished, by any health care provider for, to, or on behalf of a patient
8 during the patient's medical care, treatment, or confinement.
9 (11) "Health care provider" includes any person, partnership, association, corporation, or
10 other facility or institution who causes to be rendered or who renders health care or professional
11 services as a hospital, physician, registered nurse, licensed practical nurse, nurse-midwife, dentist,
12 dental hygienist, optometrist, clinical laboratory technologist, pharmacist, physical therapist,
13 podiatric physician, psychologist, chiropractic physician, naturopathic physician, osteopathic
14 physician, osteopathic physician and surgeon, audiologist, speech-language pathologist, clinical
15 social worker, certified social worker, social service worker, marriage and family counselor,
16 practitioner of obstetrics, or others rendering similar care and services relating to or arising out of
17 the health needs of persons or groups of persons and officers, employees, or agents of any of the
18 above acting in the course and scope of their employment.
19 (12) "Hospital" means a public or private institution licensed under Title 26, Chapter 21,
20 Health Care Facility [Licensure] Licensing and Inspection Act.
21 (13) "Licensed practical nurse" means a person licensed to practice as a licensed practical
22 nurse as provided in Section [58-31-6] 58-31b-301.
23 (14) "Malpractice action against a health care provider" means any action against a health
24 care provider, whether in contract, tort, breach of warranty, wrongful death, or otherwise, based
25 upon alleged personal injuries relating to or arising out of health care rendered or which should
26 have been rendered by the health care provider.
27 (15) "Marriage and family therapist" means a person licensed to practice as a marriage
28 therapist or family therapist under Section 58-60-405.
29 (16) "Naturopathic physician" means a person licensed to practice naturopathy as defined
30 in Section 58-71-102.
31 (17) "Nurse-midwife" means a person licensed to engage in practice as a nurse midwife

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1 under Section [58-44a-302 or 58-44a-305] 58-44a-301.
2 (18) "Optometrist" means a person licensed to practice optometry under Title 58, Chapter
3 16a, Utah Optometry Practice Act.
4 (19) "Osteopathic physician" means a person licensed to practice osteopathy under Title
5 58, Chapter 68, Utah Osteopathic Medical Practice Act.
6 (20) "Patient" means a person who is under the care of a health care provider, under a
7 contract, express or implied.
8 (21) "Pharmacist" means a person licensed to practice pharmacy as provided in Section
9 58-17a-301.
10 (22) "Physical therapist" means a person licensed to practice physical therapy under Title
11 58, Chapter 24a, Physical Therapist Practice Act.
12 (23) "Physician" means a person licensed to practice medicine and surgery under Title 58,
13 Chapter 67, Utah Medical Practice Act.
14 (24) " Podiatric physician" means a person licensed to practice podiatry under Title 58,
15 Chapter [5] 5a, Podiatric Physician Licensing Act.
16 (25) "Practitioner of obstetrics" means a person licensed to practice as a physician in this
17 state under Title 58, Chapter 67, Utah Medical Practice Act, or under Title 58, Chapter 68, Utah
18 Osteopathic Medical Practice Act.
19 (26) "Psychologist" means a person licensed under Title 58, Chapter 61, Psychologist
20 Licensing Act, to practice psychology as defined in Section 58-61-102.
21 (27) "Registered nurse" means a person licensed to practice professional nursing as
22 provided in Section [58-31-9] 58-31b-201.
23 (28) "Representative" means the spouse, parent, guardian, trustee, attorney-in-fact, or other
24 legal agent of the patient.
25 (29) "Social service worker" means a person licensed to practice as a social service worker
26 under Section 58-60-305.
27 (30) "Speech-language pathologist" means a person licensed to practice speech-language
28 pathology under Title 58, Chapter 41, Speech-language Pathology and Audiology Licensing Act.
29 (31) "Tort" means any legal wrong, breach of duty, or negligent or unlawful act or
30 omission proximately causing injury or damage to another.
31 Section 41. Repealer.

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1 This act repeals:
2 Section 58-31-1, Short title.
3 Section 58-31-2, Definitions.
4 Section 58-31-3, Boards created -- Membership.
5 Section 58-31-4, Functions of Board of Nursing and Prescriptive Practice Board.
6 Section 58-31-5, Peer review committees created -- Duties.
7 Section 58-31-6, License required -- License classifications.
8 Section 58-31-6.5, Exceptions from licensure.
9 Section 58-31-7, Qualifications for licensure.
10 Section 58-31-8, Qualifications for licensure -- Graduates of non-approved nursing
11 programs.
12 Section 58-31-9, Qualifications for admission to the examinations.
13 Section 58-31-10, Expiration of license -- Renewal.
14 Section 58-31-11, Temporary license.
15 Section 58-31-12, Licensure by endorsement.
16 Section 58-31-13, Grounds for denial of licensure and disciplinary proceedings.
17 Section 58-31-13.5, Penalty for unlawful conduct.
18 Section 58-31-15, Prescriptive authority.
19 Section 58-31-16, Consulting physician -- Limitation.
20 Section 58-31-17, Administration of anesthesia.
21 Section 58-31-18, Minimum standards for nursing programs -- Approval of nursing
22 education programs -- Unlawful conduct of nursing education program.
23 Section 58-31-19, Immunity from liability.
24 Section 58-31-20, Reporting of disciplinary action -- Immunity from liability.
25 Section 58-31-21, Continuing education.
26 Section 58-31-22, Practice within limits of competency.
27 Section 58-44a-701, Parents delivering their children.
28 Section 42. Effective date.
29 This act takes effect on July 1, 1998.


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Legislative Review Note
as of 2-4-98 5:32 PM

A limited legal review of this bill raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

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